Nondense mammographic area and risk of breast cancer
Nondense mammographic area and risk of breast cancer
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DOI：
10.1186/bcr3041
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发表时间：
2011-01-01
影响因子：
7.4
通讯作者：
Tamimi, Rulla M.
中科院分区：
文献类型：
--
作者：
Pettersson, Andreas;Hankinson, Susan E.;Tamimi, Rulla M.
前言：乳房X光照片上致密区域百分比与乳腺癌风险之间的强烈关联的潜在机制尚不清楚。方法：我们在《护士健康研究》和《护士健康研究II》中对诊断前钼靶密度测量与乳腺癌风险进行了嵌套病例对照研究。464例患者和998名对照获得了绝经前乳腺摄影，960例和1662名对照获得了绝经后乳腺摄影。结果：绝经前女性绝对值密度较高(OR(三分位数)(3)(VS)(1)=2.01，95%CI=1.45~2.77)，绝经后女性(OR(五分位数)(5)(VS)(1)=2.19，95%CI=1.65~2.89)发生乳腺癌的风险较大。绝经前女性(OR(三分位数)(3)(VS)(1)=0.51，95%CI=0.36~0.72)和绝经后女性(OR(五分位数)(5)(VS)(1)=0.46，95%CI=0.62)患乳腺癌的风险随绝经前女性绝对值增加而降低。当我们在同一统计模型中同时包括绝对致密区域和绝对非致密区域时，这些关联的变化最小。不出所料，密度百分比是两组乳腺癌的最强危险因素。结论：我们的结果显示绝对密度区域与乳腺癌风险独立正相关，而绝对非密度区域与乳腺癌风险独立负相关。由于脂肪组织在放射学上是非致密的，这些结果表明脂肪乳房组织在乳腺癌的发生中可能具有保护作用。
Introduction: The mechanisms underlying the strong association between percentage dense area on a mammogram and the risk of breast cancer are unknown. We investigated separately the absolute dense area and the absolute nondense area on mammograms in relation to breast cancer risk.Methods: We conducted a nested case-control study on prediagnostic mammographic density measurements and risk of breast cancer in the Nurses' Health Study and the Nurses' Health Study II. Premenopausal mammograms were available from 464 cases and 998 controls, and postmenopausal mammograms were available from 960 cases and 1,662 controls. We used a computer-assisted thresholding technique to measure mammographic density, and we used unconditional logistic regression to calculate OR and 95% CI data.Results: Higher absolute dense area was associated with a greater risk of breast cancer among premenopausal women (OR(tertile) (3) (vs) (1) = 2.01, 95% CI = 1.45 to 2.77) and among postmenopausal women (OR(quintile) (5) (vs) (1) = 2.19, 95% CI = 1.65 to 2.89). However, increasing absolute nondense area was associated with a decreased risk of breast cancer among premenopausal women (OR(tertile) (3) (vs) (1) = 0.51, 95% CI = 0.36 to 0.72) and among postmenopausal women (OR(quintile) (5) (vs) (1) = 0.46, 95% CI = 0.34 to 0.62). These associations changed minimally when we included both absolute dense area and absolute nondense area in the same statistical model. As expected, the percentage dense area was the strongest risk factor for breast cancer in both groups.Conclusions: Our results indicate that absolute dense area is independently and positively associated with breast cancer risk, whereas absolute nondense area is independently and inversely associated with breast cancer risk. Since adipose tissue is radiographically nondense, these results suggest that adipose breast tissue may have a protective role in breast carcinogenesis.